Klinik Hirslanden

Enquiries: please use the Hirslanden Enquiry Form

Hirslanden Neuropelveology Clinic

The Neuropelveology Centre is home to a team of physicians specialised in the integral diagnosis and treatment of pain, diseases and functional disturbances of the small pelvis that have a neurological origin.

Professor Marc Possover, MD, the medical director of the Neuropelveology Centre, is recognised worldwide as a leader in laparoscopic surgery of the nerves located in the small pelvis.

Thanks to ultramodern techniques and close interdisciplinary collaboration with other Hirslanden clinics, every patient can be sure of receiving the best advice and treatment possible.

Prof. Marc Possover
FMH Specialist for gynaecology and obstetrics
neuropelveology

Dr Klaus-Peter Henle
FMH Specialist for gynaecology and obstetrics
neuropelveology

Chronic abdominal pain, sciatica, phantom pain following leg amputation, multiple sclerosis, extensive endometriosis and bladder and bowel dysfunction are treated in close interdisciplinary collaboration with other specialists at this new centre.

Laparoscopy is the method of choice to identify and treat the different organic causes of chronic lower abdominal pain (such as adhesions, endometriosis or inflammation). Neuropelveology goes one step further by offering the possibility to directly treat the pelvic nerves responsible for pain.

For instance, a nerve lesion that results from a surgical stitch is treated by removing the stitch altogether. Such corrective action must take place at an early stage. Indeed, the presence of a nerve lesion over a prolonged period of time may cause the brain to develop pain memory, resulting in chronic pain, and thus requiring significantly more complex antalgic treatment.

Visit the Neuropelveology Centre web page for pain treatment for more details, including neurosurgical options, pudendal pain, ischialgia, chronic pain syndrome, illinguinal pain, phantom and stump pain, polyneuropathy and refractory endometriosis.

People who are weary of their long case histories can start kindling hope again.

Treatment of Pain

Restoring Function

Neuropelveology offers the possibility to restore specific pelvic functions by electrostimulating the relevant nerves. This approach is used to treat neurogenic vesical and intestinal dysfunction. Thus, nerve electrostimulation can be used to treat incontinence, hypercontinence (urinary retention), vesical sphincter dyssynergia and rectum sphincter dyssynergia (dysharmony in contractions).

Dyssynergia is caused by insufficient interactions between the muscles needed for a given function. In paralyses caused by lesions of the spinal cord, important signals originating in the central nervous system are prevented from reaching the peripheral regions (the organs) even if the peripheral nerves in the pelvis are preserved and capable of stimulating the muscles they target, the intestines and the bladder.

restoring pelvic function by electrostimulation

Functional electrostimulation (FES) of the small pelvis nerves may help restore function in such cases.

Visit the Neuropelveology Centre web page for restoration of function for more details, including bladder and prostate complaints, Fowler's Syndrome, postoperative vesical atonia, vesical and intestinal incontinence, spina bifida, and paraplegia induced by spinal cord trauma.

Preseving Function in Women

The most important clinical application is laparoscopic surgery in the small pelvis. Thanks to this technique, intervention is possible without interfering with the sexual, vesical and intestinal functions of the different organs.

Examples include laparoscopic resections of uterine myomas and partial removal of the uterus with the preservation of the cervix (LASH) in the treatment of benign uterine tumours (Uterus myomatosus). This method helps reduce surgery to a minimum and fully preserves the nerves that are located in the operated region.

A clear decrease in previously high frequencies of postoperative vesical dysfunction was demonstrated in a study conducted on 273 patients who underwent radical laparoscopic surgery for cervical cancer or rectal endometriosis.

In radical pelvic surgery (such as radical hysterectomy for uterine or cervical cancer or radical prostate or rectum resection), pelvic function can only be preserved if the nerves are identified individually by the LANN technique and if they are subsequently protected during the intervention.

Thanks to the techniques employed, only 1% of the patients experienced functional disturbances compared to 20 to 40% in traditional surgery as reported in the literature.

Visit the Neuropelveology Centre web page for women for more details, including conservative hysterectomy, cervical cancer surgery and endometriosis surgery.

laparascopic surgery of the small pelvis for women

Enquiries: please use the Hirslanden Enquiry Form.

Zurich, Switzerland

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Important note to all patients

PPM Consult Ltd. promotes selected clinics and certain specialities within individual hospitals in association with Medilux Healthcare Ltd. (MHL), where we believe the standards of care or medical equipment to be exceptional. We provide you with general information but we cannot advise or enter into correspondence about individual cases and we do not arrange or facilitate treatments. We shall not be responsible for the outcome of any treatment or failure to diagnose or treat and we recommend that all patients obtain professional medical advice on their proposed treatments.